Intranasal insulin: the effects of three dose regimens on postprandial glycaemic profiles in type II diabetic subjects

Ismail, I.S. and Coates, P.A. and Luzio, S.D. and Griffiths, I. and Ollerton, R.L. and VØlund, A. and Owens, D.R. (1995) Intranasal insulin: the effects of three dose regimens on postprandial glycaemic profiles in type II diabetic subjects. Diabetic Medicine, 12. pp. 235-239. ISSN 0742-3071

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Abstract

In both fasting normal and diabetic subjects, nasally administered insulin achieves significant falls in plasma glucose concentrations. Repeated administration before and during a meal has been necessary to lower postprandial glycaemic excursion in subjects with NIDDM. We have studied the use of Novolin® Nasal which employs a non-irritant, lecithin-based enhancer as a vehicle for human insulin, on postprandial glucose profiles in NIDDM subjects to determine efficacy, optimal dose frequency, and tolerability. Seventeen NIDDM subjects (15 men, 2 women) participated in a randomized, partially blinded, placebo-controlled, crossover trial of three active treatment regimens (nasal insulin, 120 U at 0 min, 60 U at 0 and +20 min or 120 U at +20 min) in relation to a standardized mixed meal given at 0 min. All active treatments significantly reduced postprandial glucose concentrations compared to placebo. lntranasal insulin given at 0 min at a dose of 60 U or 120 U resulted in a 50 % reduction in postprandial incremental glucose compared to placebo over the first 2 h, whereas treatment with 60 U both at 0 and 20 min lead to a 70 % reduction over the 240 min postprandial period. Post-prandial intravenous insulin was the least effective. There were no episodes of symptomatic hypoglycaemia. Local tolerability was excellent with only four reports of transient nasal irritation out of a total of 68 doses. The delivery device was accurate with intra-device CV of delivered dose of 4.8 %. We conclude that nasal insulin is effective in reducing postprandial glycaemia in subjects with NIDDM and is well tolerated. Repeated dosing achieved the greatest reduction in postprandial glycaemic responses to a mixed meal.

Item Type: Article
Uncontrolled Keywords: Nasal insulin; Mixed meal tests; NIDDM
Subjects: R Medicine > R Medicine (General)
Divisions: Faculty of Medicine
Depositing User: Ms. Izzan Ramizah Idris
Date Deposited: 10 Jun 2014 01:41
Last Modified: 10 Jun 2014 01:41
URI: http://eprints.um.edu.my/id/eprint/10403

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